Effect of Combination of Acapella Device and Breathing Exercises on Treatment of Pulmonary Complications After Upper Abdominal Surgeries
Journal of Surgery
Volume 4, Issue 2-1, March 2016, Pages: 10-14
Received: Oct. 21, 2015; Accepted: Nov. 4, 2015; Published: Dec. 14, 2015
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Nesma M. Allam, Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
Mohammed M. Khalaf, Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
Wael N. Thabet, Department of General Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
Zizi M. Ibrahim, Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
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Introduction: Background. Upper abdominal surgery alters postoperative pulmonary function, as observed by impairment of lung volumes such as total lung capacity, vital capacity. Impaired clearance of sputum results in a vicious cycle of colonization and infection of bronchi with pathogenic organisms, dilation of bronchi and further production of sputum. The aim was to investigate the effect of combination of Acapella device and breathing exercises on treatment of post operative pulmonary complications after upper abdominal surgeries. Subjects and methods: Sixty patients underwent upper abdominal surgery were assigned randomly into two equal groups; their ages ranged from 20-50 years. The study group received breathing exercises, Acapella device and traditional chest physical therapy program (postural drainage. percussion, vibration, cough training and early ambulation). Control group received traditional chest physical therapy program (postural drainage. percussion, vibration, cough training and early ambulation). All groups received three sessions per week for four successful weeks. The data were collected before and after the same period of treatment for both groups. Evaluation procedures were carried out to measure pulmonary function: Forced vital capacity (FVC) and Forced expiratory volume in one second (FEV1) using electronic spirometer. Results: Post treatment results showed that there was a significant improvement difference in FVC and FEV1 in both groups in favor of the study group. Percentage of improvement of FVC in the study group was 42.28%, while it was 16.31%in the control group. Percentage of improvement of FEV1 in the study group was 49.05%, while it was 20.79%in the control group. Conclusion: Combination of Acapella device and breathing exercises were considered to be an effective modality for treatment of postoperative pulmonary complications and removal of secretions after upper abdominal surgeries.
Acapella Device, Breathing Exercises, Pulmonary Complications, Spirometer, Upper Abdominal Surgeries
To cite this article
Nesma M. Allam, Mohammed M. Khalaf, Wael N. Thabet, Zizi M. Ibrahim, Effect of Combination of Acapella Device and Breathing Exercises on Treatment of Pulmonary Complications After Upper Abdominal Surgeries, Journal of Surgery. Special Issue: Gastrointestinal Surgery: Recent Trends. Vol. 4, No. 2-1, 2016, pp. 10-14. doi: 10.11648/j.js.s.2016040201.13
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This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Chiavegato L, Jardim J, Faresin S and Juliano Y. Altered respiratory function in laparoscopic cholecystectomy. J Pneumol; 2000, 26(2): 69-76.
Grams S, Ono L, Noronha M, Schivinski C and Paulin E. Breathing exercises in upper abdominal surgery: A systematic review and meta- analysis. Revista Brasileira de Fisioterapia; 2012, 16 (5): 345-53.
Dronkers J, Veldman A, Hoberg E, Van Der Waal C and Van Meeteren N. Prevention of pulmonary complications after upper abdominal surgery by preoperative intensive inspiratory muscle training a randomized controlled pilot study; 2008, (22): 134–142.
Johnson R, Arozullah A, Neumayer L, Henderson W, Hosokawa P and Khuri S. Multivariable predictors of postoperative respiratory failure after general and vascular surgery: Results from the patient safety in surgery study. J Am Coll Surg; 2007, (204): 1188–98.
Arozullah A, Daley J, Henderson W and Khuri S. Multifactorial risk index for predicting postoperative respiratory failure in men after major non cardiac surgery. The national veterans administration surgical quality improvement program. Ann Surg; 2000, (232): 242–53.
Sharon M, Alice Y and Phil M. Postural drainage or flutter device in conjunction with breathing and coughing compared to breathing and coughing alone in improving secretion removal and lung function in bronchiectasis. Hong Kong Physical therapy Journal; 2003, 21: 29-36.
Volsko T, Difiore J and Chatburn R. Performance comparison of two oscillating positive expiratory pressure devices: Acapella versus flutter. Respir Care; 2003, (48): 124-130.
McIlwaine M. Physiotherapy and airway clearance techniques and devices. Paediatric Respiratory Reviews; 2006, (7): 220–222.
Perry A and Potter P. Mosby's Pocket Guide to nursing skills and procedures: Acapella device. USA: Elsevier Health Sciences. 2015, (8): 1-3.
Wolkove N, Kamel H, Rotaple M and Baltzan M. Use of a mucus clearance device enhances the bronchodilator response in patients with stable COPD. Chest; 2002, (121): 702-707.
Alves Silva C, Santos J, Jansen J and De Melo P. Laboratory evaluation of the Acapella device: Pressure characteristics under different conditions and a software tool to optimize its practical use. Respir Care.; 2009, 54 (11): 1480-1487.
Mueller G , Bersch-Porada I, Koch-Borner S, Raab A , Jonker M, Baumberger M and Michel F. Laboratory evaluation of four different devices for secretion mobilization: Acapella choice, green and blue versus water bottle . Respiratory care; 2014, 59(5): 673–677.
Nicolini A, CardiniF, Landucci N, Lanata S , Ferrari-Bravo M and Barlascini C. Effectiveness of treatment with high-frequency chest wall oscillation in patients with bronchiectasis. Pulmonary Medicine; 2013, 13 (21): 2-8.
Mohamed A, Taha M and Bahey El-Deen H. Effects of positive expiratory pressure breathing on functional outcomes in patients with chronic obstructive pulmonary disease after major abdominal surgeries: randomized controlled trial. International Journal of Advanced Research; 2014, (2)7: 784-801.
Johansson H, Sjöholm R, Stafberg A and Westerdah E. Breathing exercises with positive expiratory pressure after abdominal surgery–The current physical therapy practice in Sweden. J Anesthe Clinic Res; 2013, 6(4): 1-4.
Abu-Rayan M, Afifi M, Othman M, El- Ganady A and Mikhael B. Evaluation of the single and combined roles of oscillating positive expiratory pressure device and conventional multimodality chest physiotherapy in mechanically ventilated COPD. Alexandria Journal of medicine; 2009, 45 (2): 354-364.
Lamari N, Martins A, Oliveira J, Marino L and Valerio N. Bronchiectasis and clearence physiotherapy: emphasis in postural drainage and percussion. Braz J Cardiovasc Surg; 2006, 21(2), 206-210.
Augustine A, AlaparthiG, Anand R and Mahale A. Chest physiotherapy during immediate postoperative period among patients undergoing laparoscopic surgery- a randomized controlled pilot trail. International Journal of Biomedical And Advance Research; 2013, 4(2): 118-122.
Abd Elgaphar S and Soliman G. The effect of early post-anesthetic chest physiotherapy nursing intervention on patients undergoing upper abdominal surgery. Journal of Nursing and Health Science; 2015, 4 (4): 1940-2320.
Pryor J, Tannenbaum E, Scott S, Burgess J, Cramer D, Gyi K and Hodson M. Beyond postural drainage and percussion: Airway clearance in people with cystic fibrosis. Journal of Cystic Fibrosis; 2010, 9 (3), 187-192.
Patterson J, Bradley J, Hewitt O, Bradbury I, and Elborn J. Airway clearance in bronchiectasis: A randomized crossover trial of active cycle of breathing techniques versus Acapella. Respiration; 2005, 72: 239–242.
Murray M, Pentland J and Hill A. A randomized crossover trial of chest physiotherapy in non-cystic fibrosis bronchiectasis. European Respiratory Journal; 2009, 34(5): 1086-1092.
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